Herald View: Encephalitis deaths expose limitations of Ayushman Bharat

With reports of deaths of almost 150 children from Encephalitis in Muzaffarpur in Bihar, and with more dying every day, it is pertinent to ponder whether our health system has completely collapsed. About 400 children are admitted in the hospital in Muzaffarpur town alone. About two years back, more than 500 children had died in Gorakhpur in Uttar Pradesh from the same disease.

But it looks like that was not enough of a wake-up call for the states or the Centre. While health is a state matter, it needs to be noted here that both Bihar and Uttar Pradesh are NDA-ruled states.

Data analysis of reports of World Health Organisation, World Bank and Unicef, and its comparison with statistics for Muzaffarpur district alone shows that when it comes to nutrition of children and mothers, most African countries perform better than Muzaffarpur. Acute malnutrition invariably leads to extremely low immunity, rendering the children incapable of fighting the disease. The scale of malnutrition in Muzaffarpur is unimaginable.

Nearly 48% children under the age of 5 are stunted, 17.5% are wasted while 42% are underweight. The state’s medical authorities initially blamed the deaths on heat wave and hypoglycaemia (sudden drop in blood sugar levels). But after much criticism and media attention, they have acknowledged the two most critical reasons for the deaths: malnutrition and ill-equipped primary health centres.

Encephalitis is not a new killer in Muzaffarpur. Between 2010 and 2014, more than 1000 children have died of the disease in the district. But still, the authorities and administration fail to show a modicum of seriousness in tackling the problem. Encephalitis can be cured.

Acute Encephalitis Syndrome can be contained if the child is administered dextrose within four hours of the onset of symptoms. But every outbreak since 2010 has shown that Muzaffarpur’s primary health centres, the first port of call for most patients, simply are not adequate to deal with the disease. Most do not have equipment to check blood sugar levels.

The Sri Krishna Medical College and Hospital, the nodal hospital in Muzaffarpur tasked to deal with the disease, does not even have a virology laboratory. The Supreme Court has agreed to hear a plea for setting up a special panel of medical experts to tackle the situation. The same plea also seeks a direction to the Centre for providing all necessary medical equipment and other supports for battling the disease. The plea has rightly put the onus of this on the state government and the Centre.

The lack of seriousness of the Bihar government can be gauged from the fact the state’s health minister was enquiring about cricket score of the India-Pakistan ODI game in a meeting convened last Sunday to firefight the situation. It looks like India’s citizens now need court directives to secure their lives from diseases. Its governments and ministers are not just simply incapable. They simply don’t care. One just hopes our judiciary won’t let our children down the way our government has clearly done.